Tag: health care

The more this debate continued, the more we saw how little Donald J. Trump knows. As he did in the first debate, he is never able to speak in specifics. He thinks that if he blurts out key words and insults, that will be enough to reach undecided voters. Instead, he is speaking only to his base, making them froth with even more hatred. A debate is designed to allow us to learn more about the candidates. Tonight we’ve learned or been reminded that Mr. Trump doesn’t know how American governance works — assuming that alone, as one senator, Hillary Clinton could impose her will upon the entire Congress and the Republican president at the time.

He is unfamiliar with where America’s tax rate stands in a global context. He has no understanding of what it would take to ensure that all Americans can receive health care without a federal mandate. He has no understanding of international relations and the travesty that is taking place in Syria or what the word “humanitarian” means. The list goes on, and on. It is crystal clear that a Trump presidency would lead both the United States and the rest of the world into a dystopia the likes of which even the darkest of novelists cannot fathom.

Hillary Clinton is dealing with a unique challenge — having to stay sharp with an incompetent opponent. She managed to remain on message throughout the debate. She offered several specifics while always clearly demarcating the difference between her and Mr. Trump. She demonstrated grace under pressure. And in the end, when asked to say something positive about her opponent, she reminded us of just how much she outclasses Mr. Trump as a political candidate. She complimented his children despite how easy and satisfying it would have been to say the truth — that no, there is nothing commendable about Donald Trump.

Roxane Gay is an associate professor at Purdue University, the author of “Bad Feminist” and the forthcoming “Hunger,” and a contributing opinion writer.

Donald Trump is not a riddle, a monster or a mystery. Trump has many antecedents in American history, and his ascendance was the wholly predictable result of a broken political culture.

For progressives and those others worried about America’s deep political rot, “Trumpmania” represents a supreme and rare teachable moment, one that exposes the racism, authoritarianism, and socio-political anxieties of white movement conservatives in the post civil rights era and the age of Obama.

In many ways, Donald Trump has written a virtual textbook about the worst aspects of present-day, right-wing American politics. This book, if ever published, would include the following important concepts.

1. White identity politics. Donald Trump has been endorsed by prominent white supremacists and white nationalists as their chosen candidate.

(Political socialization begins in the home. According to recently discovered news reports from 1927, Trump’s father was likely at least a sympathizer with, if not a member, of the Ku Klux Klan.)From the end of the Civil Rights Movement onward, the Republican Party has used a strategy of white grievance mongering known as the Southern Strategyto mobilize its voters.

As a complement to the Southern Strategy, since the election of Barack Obama, the right-wing Fox News hate media has obsessively channeled racist narratives such as “birtherism,” “black crime,” and most recently the lie that the Black Lives Matter movement is an anti-white hate group.

The Republican base is almost entirely white, increasingly alienated and upset about the perceived decline in white people’s political and social power, and feeling under siege in a country that is becoming more racially diverse. Donald Trump has combined the old fashioned racism of overt white supremacists with the modern white racist “dog whistle” politics of the Republican Party. He is the new face of American white identity politics in the 21st century.

2. Right-wing producerism. Donald Trump has presented himself as an “everyman” who can speak for the “regular” people who feel alienated and frustrated by the Washington D.C. “insiders” who do not look out for the “little guy.” This is the crudest form of populist politics. Trump then aims his supporters’ anger towards an enemy:immigrants from Mexico who are coming to American to supposedly steal jobs while they rape and murder white women; or the Chinese he presents as a stereotypical devious and sneaky “yellow peril” Asian foe that only Trump can outmaneuver and conquer.

In this script, Donald Trump then promises to protect benefits like Social Security and health care, while creating a more fair tax code for “hardworking” (white) Americans who are under siege by “parasites”, i.e. the poor on one extreme, and the corporate monied classes on the other. Trump’s “makers and takers” language is then mated with hostility to some type of Other in order to excite and mobilize conservatives via right-wing populist zeal.

3. Herrenvolk politics (a system in which minorities are disenfranchised while the ethnic majority holds sway). Donald Trump is using white identity politics to win supporters. Combining overt and subtle racism, part of Trump’s appeal is that he promises to protect the resources and democratic rights of white Americans against their supposed exploitation and theft by non-whites. This is one of the foundations of right-wing producerism.

In the right-wing conservative imagination, real Americans are “hard working,” “Christian” and “white.”Their rights and privileges are to be protected at all costs against lazy black and brown people who are welfare queens, thugs or “illegal” immigrants. The social safety net—while torn at by the 1 percent and right-wing plutocrats—exists to serve white peopleand “real Americans” before any other group. As was seen in Nazi Germany, South Africa, Israel, and other racist apartheid societies, the State exists to provide support and service to the “ingroup” or “master race” while the “outgroup” is denied the same benefits and rights. This is the core of Donald Trump’s herrenvolk appeal.

4. Social dominance behavior. Donald Trump’s supporters are drawn from the same core of aggrieved and angry white voters who comprise the Tea Party wing of the GOP.Research on this group shows that they are racially resentful, fearful of social change, hostile to people who are not like them, believe in natural hierarchies and order, seek out strong leaders, are deferent to authority, and exhibit a type of “bullying politics.” In many ways,Trumpmania is a frightening reflection of the authoritarian values that have infected American conservatives.

5. Know-Nothings. Donald Trump’s nativist, xenophobic and racist politics are the latest version of the 19th century American political movement known as the Know-Nothings. The Know-Nothings 1856 party platform included demands that “Americans must rule America; and to this end native-born citizens should be selected for all state, federal and municipal offices of government employment, in preference to all others…”

This is not unlike Trump’s ginning up of white anxiety and violence towards non-white immigrants.

6. The strong father and “manliness.” Donald Trump repeatedly talks about “strength” while slurring Barack Obama and other political enemies as “weak” or as “pansies.”

Trump is also not limited by what the right-wing sees as “weak” “liberal” notions of “political correctness” as he insults women and throws verbal bombs at any person who disagrees with him.

Right-wing ideologues and authoritarians idolize the strong father figure, one who often uses punitive means of discipline to maintain high levels of control over his wife and children. (The right-wing’s latest slur, “cuckservative,” also reflects their anxieties about white masculinity, race, and sexual potency.)

Donald Trump uses gendered language because America’s political class often defaults to a framework where the Democrats are framed as being weak, feminine or too intellectual. By comparison, the Republicans are depicted as strong, manly and decisive.

Donald Trump is playing the role of strongman for the right-wing ideologues and movement conservatives who are aroused by such a figure because the latter fulfills a psychological need for security and protection in a world they view as dangerous and changing too rapidly. His name-calling, bullying swagger, and indifference to norms of comportment and reasonable behavior are central to Trump’s popularity.

7. Performance art and spectacular politics. Donald Trump’s political success is a product of reality television show culture.

Reality television shows are scripted. The genre is wildly popular among American viewers because it is part of an “empire of illusion” that distracts and confuses the public while allowing them to live out their fantasies and wish fulfillment.

In keeping with that dynamic, Trump’s obsessions with “ratings” and public opinion polls that supposedly show his “popularity” are the result of a broken civic and moral culture that equates “likes” on Facebook or “votes” on American Idol with substantive measures of virtue or human value.

Ultimately, Donald Trump is using his background as a reality TV show host, business celebrity, and fan of professional wrestling to engage in a type of ridiculous and exaggerated performance art that mocks the notion of normal politics. Because Trump is not interested in normal politics—Trump is reality TV mixed with professional wrestling—he is relatively immune from derailment or substantive engagement by the news media or his political rivals in the Republican Party.

8. Conspiracy theories and the paranoid style. Donald Trump was one of the most prominent advocates of “Birtherism”—a belief that Barack Obama, the United States’ first black president, was somehow not eligible for the office because he is not a “real” citizen.

This is an absurdly racist claim; nevertheless it is one that is still believed by 66 percent of Trump supporters and 45 percent of Republicans. Birtherism was the first of many conspiracy theories that would be invented by the right-wing media in the age of Obama. Obsessions about Planned Parenthood, ACORN and Benghazi would follow. These delusions are part of a long pattern of right-wing paranoia that Richard Hofstadter detailed in his landmark 1964 essay, “The Paranoid Style in American Politics.”

The right-wing media and the Republican Party’s embrace of conspiracy theories and paranoid delusions contribute to a broken political system because too much time is spent on the absurd instead of doing the work of real governance. The conspiracy fantasies of Donald Trump and the American right-wing constitute an alternative reality that is immune from facts. Consequently, these beliefs function as a type of religious cult where faith—what is a belief that cannot be proven by ordinary means—is substituted for empirical reality.

Donald Trump’s “birtherism” alternate reality is compelling and exciting for those who believe in it. Such conspiranoid delusions are dangerous because they create extreme political polarization, a political system that cannot fulfill its basic functions, encourage violence, and tear at the common beliefs and values that create a sense of political legitimacy and community in the United States.

Informed citizens can create positive political change. An ignorant public can be easily swayed, manipulated, and duped to act against their self-interest and the Common Good.

Donald Trump is a charismatic figure who embodies the fears, hopes, and anxieties of an aggrieved and frustrated white America. He is the hero they are desperate for. He is a product of a particular coincidence of broken politics, an irresponsible Fox News echo chamber media, and a scared and racially resentful public.

Bernie Sanders is leading Hillary Clinton in early primary states, and he’s gaining on her in national polls. Major media outlets are starting to treat Senator Sanders seriously, but not necessarily with complete honesty. Take for example Laura Meckler’s article in the Wall Street Journal earlier this week. It was provocatively titled “Price Tag of Bernie Sanders’s Proposals: $18 Trillion.”

The article starts off by dismissing Sanders’s campaign as a long-shot, and then goes on to call his proposals “the largest peacetime expansion of government in modern American history.”

“In all” Meckler writes, “he backs at least $18 trillion in new spending over a decade… a sum that alarms conservatives and gives even many Democrats pause.”

That estimate may give conservatives and corporate Democrats pause, but the whole article should give any reader who can do simple arithmetic pause. One red flag is that the click-bait headline makes it seem like the piece is talking about a one- or maybe two-term estimate of what Bernie’s budgets might look like. Or even more extreme; that just getting his proposals off the ground would take $18 trillion.

But the reality is that we’re only looking at $1.8 trillion a year under Bernie’s sweeping proposals. But that’s just a little editorial sleight of hand to drive traffic to their site right? Well, not quite.

You see, the Wall Street Journal piece cited research by Gerald Friedman, a professor of economics at the University of Massachusetts at Amherst. And there was just one small problem with their interpretation of his research. They blatantly omitted his conclusion.

But in the age of information, major newspapers are rightfully under more scrutiny than ever. Professor Friedman saw the Wall Street Journal’s piece and responded in the Huffington Post with “An Open Letter to the Wall Street Journal on Its Bernie Sanders Hit Piece.”

He writes that the Journal wasn’t completely wrong: the program would involve spending $15 trillion over a decade. But they left out the key detail: it would actually save the country a total $5 trillion over those 10 years. We’d see those savings in reduced administrative waste, lower pharmaceutical and device prices, and by decreasing the rate of medical inflation.

Because the simple fact is: We, as a people, are going to spend that $15 trillion on health care anyway. The difference is that under the current model, we pay that money to private insurance companies. And those private companies have much higher levels of administrative costs, fraud and general waste than Medicare does. Another difference is that the government would be negotiating drug prices, making drugs more affordable for everyone.

And who would see that $5 trillion in savings? Businesses for one. Along with state and local governments. Because they wouldn’t have to pay for their employees’ insurance — who’d be covered by Medicare for All.

And individuals, like you and me, wouldn’t have to worry about co-payments and deductibles. Or worse, finding that the “affordable plan” that we choose doesn’t cover a necessary procedure.

You see, as Bruh1 points out over at DailyKos, the Wall Street Journal presented government spending in a fundamentally dishonest way. Because what we spend can’t be separated from what we’d save by going with different policies.

Take Bruh1’s example of shopping for a car: “You don’t buy a car by saying ‘well it would cost me 10,000 here, but the same car would cost me 7,000 there, so the price tag on the 7,000 car is too expensive.’ You say ‘it saves me 3,000 to buy from the other guy.”

And that’s the point — it’s not $15 trillion that Bernie’s plan would cost the country, because we as a people will spend that amount, and more, on health-care costs anyway.

It’s $5 trillion that we the people will save with Bernie’s plan — and get back — by adopting an efficient and affordable single-payer health-care for all system. And that would be good for everyone, and the economy as a whole.

Unfortunately the Wall Street Journal’s analysis of Bernie’s proposals isn’t just another routine example of shoddy corporate journalism. It’s an example of how the corporate media tries to discredit and discard anyone who they can’t control. And that’s not just bad news for our political process. It’s also bad news for the Fourth Estate, which really should at least try to be honest in its critique of policy issues.

Democratic presidential candidate Bernie Sanders on Monday went to a pillar of the religious right – Liberty University in Lynchburg, Va. – to make the case that fighting for economic justice is as moral an undertaking as such cornerstone issues for Christian conservatives as opposing abortion.

“It would, I think, be hard for anyone in this room to make the case that the United States today is a just society or anything close to a just society,” he said in his speech to packed convocation at the school founded by the Rev. Jerry Falwell, known for forming the Moral Majority political organization and leading its fervent crusades against gay rights, reproductive choice and other progressive positions on social issues. “There is no justice when the top one-tenth of 1 percent own almost as much wealth as the bottom 90 percent. There is no justice when all over this country people are working longer hours for lower wages, while 58 percent of all new income goes to the top 1 percent.”

Nor is there justice, he said, when “low-income and working-class mothers are forced to be separated from their new babies one or two weeks after giving birth” because “the United States is the only major country on earth that does not provide paid family and medical leave,” or when “thousands of people in this country die each year because they don’t have health insurance and don’t get to a doctor when they should.”

“I am not a theologian or an expert on the Bible or a Catholic,” he said at one point. “I am just a U.S. senator from the small state of Vermont. But I agree with Pope Francis when he says, ‘The current financial crisis… originated in a profound human crisis: the denial of the primacy of the human person! We have created new idols. The worship of the ancient golden calf has returned in a new and ruthless guise in the idolatry of money and the dictatorship of an impersonal economy lacking a truly human purpose.’”

Sanders early in his address quoted the words of Jesus Christ in the gospel of Matthew (as rendered in the New International Version, a Bible translation popular with conservatives): “So in everything, do to others what you would have them to do to you, for this sums up the Law and the Prophets.” He closed with a challenge to students seeking to discern how to apply that scripture and other themes of the Gospel to their political engagement: “I would hope very much that as part of that discussion and part of that learning process, some of you will conclude that, if we are honest in striving to be a moral and just society, it is imperative that we have the courage to stand with the poor, to stand with working people, and when necessary, take on very powerful and wealthy people whose greed, in my view, is doing this country enormous harm.”

In a question-and-answer session afterward, Liberty University Vice President for Spiritual Development David Nasser sought to show common ground with Sanders on making eradicating the vestiges of racism and racial inequality from the society a top priority. But when Nasser quoted presidential candidate Mike Huckabee in saying that racism “is a sin problem, not a skin problem,” Sanders reminded him that it took a Supreme Court, a civil rights movement and “public policy” to end segregation and lay the groundwork for improved race relations.

Sanders also challenged people who fight for “the protection of the unborn” to join him in the fight against threats to the already-born as a result of budget decisions being made by Republicans in Congress, such as proposals that he said would cause 27 million people to lose access to health care, cut billions of dollars in foods assistance to low-income families and cut funding for college aid for low-income students by $90 billion – while giving $250 billion in tax relief over the next 10 years to the top 0.2 percent of wealth holders.

A few years back I worked with a guy who was probably a genius. In fact, he often struggled in life interacting with people because his brain simply performed at a higher level than the average person. I remember asking him what his biggest belief was in making life decisions and he always, without fail, told me “think of the bigger picture.” And while I’ve always tried to be a big picture thinker, knowing him when I did helped me understand it a little better.

He always told me the biggest issue he faced when dealing with people was that he’d see things in a bigger scope that most people simply couldn’t follow. While many people tend to not see beyond a particular moment, day, week or even month, he operated with a sense of “is what I’m doing now the best course of action to set me up for success not just now, but later on.” He used to tell me people would come to him for advice every once in a while and often walk away angry because what they wanted to hear wasn’t usually what they needed to hear. He was actually one of the first people who made me aware of the fairly obvious (though I was young and had never really thought about it) human characteristic of adoring people who tell them what they want to hear, or what they understand, while condemning those who don’t. Most people really just want to be assured of what they hope will happen rather than take a good long look at what’s best for themselves in the long run. And while he wasn’t right about everything, he was fairly brilliant when it came to a lot of things. I will say as a young person at the time, this person – who I haven’t spoken to in years – made a profound impact on how I viewed life going forward. Which brings me to President Obama.

While I’m not calling him a genius, I do think he’s extremely intelligent. I also believe that his tendency to use “big picture” thinking while drafting policy is something most Republican voters simply can’t understand. Take “Obamacare” for instance. It’s not a “fix health care today” law. In fact, the law itself is made to grow and evolve over time.But, as it is now, it’s a long-term outlook on our health care. While many Republicans want to look at the “now” aspect of the Affordable Care Act, they seem unable to grasp the reality that as more Americans get health insurance, giving them access to preventable care, this lowers expenses down the road foreveryone. If people can prevent very costly heart attacks, strokes or other debilitating health issues now, that’s an overall savings for practically everyone from consumers to health insurers to doctors who now have more patients. Quite literally, improving the overall health of Americans will improve the health of this country. It even makes sense for our economy. If workers are healthier, because they have access to quality health care, that means there will be fewer people calling in sick to work, showing up sick to work (putting other employees at risk) or relying on government programs because their health conditions (that were preventable) render them unable to work at all. But to see all of that requires “big picture” thinking and Republicans seem unable to understand anything beyond the spoon-fed bumper sticker talking points they’re given by the GOP and the conservative media.

Minimum wage is similar issue. Republicans constantly paint it as a “job killer” (it’s not) while also rallying against the millions of people who are on government assistance. A good portion of the Americans who are on government assistance have jobs. If we made sure that no American working full-time had to rely on government programs just to survive, instantly we would save our country hundreds of billions of dollars over the years. Not only that, but when Americans have more money, they have more to spend. And what’s the biggest driver of economic growth? Consumer spending. More consumer spending means higher profits and higher demand, which means – more jobs. But once again, when it comes to Republicans and explaining job creation, anything outside of “tax cuts create jobs” is often too complex for many of them to understand. The same goes for war. When it comes to ISIS, Republicans just want to send in troops and “crush the terrorists.” They’ve hammered President Obama relentlessly about how he’s handled the entire situation. To many of them, they want to go in guns blazing because that’s what sounds good. But as we’ve learned by our previous war in Iraq, going into these situations haphazardly without a plan leads to absolute chaos. Remember, the existence of the ISIS we see today is a direct result of Bush’s Iraq War. When it comes right down to it, I really do believe a huge part about why so many of the non-racist Republicans are against President Obama is because many of them are simply unable to grasp his “big picture” thinking that drives a lot of his policies. That requires intelligence and far too many conservative would rather just be told what to think by Fox News. They want their policies to be so simplified and catchy that they fit on bumper stickers. It’s like I’ve often said, Democrats are trying to use science, math, reality, history and education to reason with people who deny science, don’t trust math, create their own reality, distort history and often devalue quality education. That’s a big reason why we’re not getting anywhere in this country.

Republicans may yet win the elections in November. They may end up in control of both houses of Congress come January. But in the final week before a lengthy August recess, they have shown a remarkable capacity to complicate their path to victory.

The latest blow came Thursday in what has become predictable fashion: chaos in the House. Amid fractious infighting, House leaders abruptly pulled their alternative to President Obama’s bill to deal with the influx of Central American children crossing the border. What was said to be a national crisis turned into one more problem facing deferral.

But there was more over the week that could contribute to the deteriorated brand called the Republican Party. On Wednesday, the House voted to sue Obama, an action that may cheer the party’s conservative wing but that also may appear to other voters to be a distraction at a time of major domestic and international problems.

In the background this week was talk of impeachment. Republicans rightly suggest that the White House and Democrats are doing all they can to stoke discussion of the topic as a way to raise money and motivate their base. But it is a subject that has bubbled up from the conservative grass roots of the GOP and that now bedevils Republican leaders.

Fundamentals in this election year continue to favor the Republicans. Obama’s approval rating is low and stagnant. Not much on the immediate horizon is likely to change that, given the state of the world. The economy is getting better, but many voters aren’t convinced of that. The Senate map favors Republicans, who need a net of six seats to gain control of the chamber.

This isn’t 2010 all over again by any means: The unrest is more muted. But looking toward November, it’s better to be in the Republicans’ position now than the Democrats’. Standing in the GOP’s path to victory, however, are perceptions of the party itself, nationally and in some of the states. How much self-inflicted damage is too much?

The tea party movement gives the Republicans energy, but it continues to push the party further to the right than some strategists believe is safe ground. In a number of states, strategists for the GOP say tea party positions are outside the mainstream, even the conservative mainstream.

Republicans are asking for the right to govern, to control the legislative machinery starting in 2015. But they continue to struggle with that very responsibility in the one chamber they control. How many times have Speaker John A. Boehner (R-Ohio) and his top lieutenants suffered similar embarrassments as support for leadership measures suddenly eroded in the face of a conservative revolt?

Republicans have been repeatedly criticized for not offering a governing agenda if they take power. What happened Thursday underscores why that has been so difficult. Getting the party’s factions on the same page has proved more than difficult. In some states where Republicans control the governorship and the legislature, there has been a backlash to their governing agenda. Kansas and North Carolina are two prime examples.

In Congress, Republicans have spent four years attacking the Affordable Care Act with a series of votes to repeal or defund it. But is there a Republican alternative they are collectively promoting this fall? No. Rep. Paul Ryan (Wis.) told reporters at a breakfast held by the Christian Science Monitor on Thursday that he is working on one — but that it is just one of several GOP ideas on health care.

House Republican leaders say Democrats are hypocritical to blame them for the gridlock and chaos. They point to a series of bills approved with Democratic support that are parked in the Senate with no action. They say Senate Majority Leader Harry M. Reid (D-Nev.) should let senators vote on them. But by their own high-voltage missteps, they draw attention away from that and to themselves. They reinforce a narrative that remains not in their favor.

The immigration issue offered a fresh example of the conundrum for Republicans. The border crisis presented Obama with a serious problem — substantively and politically. He offered his own plan for $3.7 billion in spending, which was too high-priced for the GOP. Their alternative called for $659 million in spending.

But at the center was an issue of power. Republicans view Obama as an out-of-control executive who has exceeded his constitutional authority and they want to take him to court (although ironically for doing something with the Affordable Care Act, delaying the employer mandate, a move they favor).

The issue of executive power extends to immigration. With comprehensive immigration reform locked down in the House and heading nowhere this year, Obama’s administration is exploring what he can do through his executive powers to accomplish some of what immigration reform legislation would do, including possibly allowing some of the adults here illegally not to face deportation.

Many House Republicans want to stop him. Some also wanted to force him to roll back what he did in 2012, when he allowed children who came into the United States illegally with their parents to stay without an immediate threat of deportation. All of that contributed to the collapse of the border bill.

It also prompted a call from at least one powerful Republican for Obama to act on his own.

“I think this will put a lot more pressure on the president to act,” House Appropriations Committee Chairman Harold Rogers (R-Ky.) told reporters on Capitol Hill. “In many ways, it was his actions and inactions that caused the crisis on the border, and we attempted in this bill to help remedy this crisis. He has the authority and power to solve the problem forthwith.”

Obama ridiculed the House for wanting to sue him. “They’re mad because I’m doing my job,” he told an audience in Kansas City, Mo., on Wednesday.

That’s a large overstatement by the president, but Republicans have handed him the argument to make through their actions and inactions.

Republicans will have five weeks outside of Washington to let things settle after Thursday’s breakdown. They will have time to regroup and try to put this moment behind them. Obama and the Democrats are still on the defensive in the battle for control in these midterm elections. But Republicans would do better if they found a way to stop hurting themselves.

The uninsurance rate continues to drop to record lows, according to polling from Gallup — and it’s declining the fastest among the communities who have historically lacked adequate access to health care. The data suggests that Obamacare is effectively expanding coverage to the people who need it the most.

Among U.S. adults, the uninsurance rate declined to 13.4 percent in April, hitting the lowest rate since Gallup began tracking the monthly data in 2008. The sharp decline in the number of people without insurance coincided with Obamacare’s first open enrollment period between October and April:

Although the uninsurance rate fell across all demographic groups, the researchers noted that it dropped particularly significantly among non-white and lower-income Americans. Those are the groups that were expected to benefit the most from the provisions in the Affordable Care Act, since they’ve traditionally suffered from higher rates of uninsurance. Compared to the fourth quarter of 2013, the uninsurance rate among black adults fell by 7.1 percentage points, the biggest drop among any group. Among Hispanics, the rate is down 5.5 points. And among Americans with an annual household income of less than $36,000, the rate also dropped by 5.5 points.

But the recent gains aren’t being dispersed equally across states. More than 20 GOP-led states continue to resist Obamacare’s optional Medicaid expansion, a move that’s denying health care from millions of the working poor. Refusing to expand Medicaid disproportionately harms low-income people of color. Furthermore, the states resisting Medicaid already had higher uninsurance rates to begin with, and are home to people who tend to be poorer and sicker than the residents in other states.

Unsurprisingly, previous research conducted by Gallup has found that the uninsurance rate is falling the fastest in the states that have embraced Obamacare, including its expansion of Medicaid. Meanwhile, the red states that have refused to lift a finger to further health reform have effectively ensured that residents there don’t know as much about their options under the law.